"Scrap Tire Hauler Registration Form" - New Mexico

Scrap Tire Hauler Registration Form is a legal document that was released by the New Mexico Environment Department - a government authority operating within New Mexico.

Form Details:

  • Released on January 31, 2019;
  • The latest edition currently provided by the New Mexico Environment Department;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of the form by clicking the link below or browse more documents and templates provided by the New Mexico Environment Department.

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Download "Scrap Tire Hauler Registration Form" - New Mexico

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NEW MEXICO
ENVIRONMENT DEPARTMENT
Solid Waste Bureau
1190 Saint Francis Drive, Room N-2150
P.O. Box 5469
Santa Fe, New Mexico 87502-5469
Telephone: (505) 827-0197 Facsimile: (505) 827-2902
www.env.nm.gov/solid-waste/
SCRAP TIRE HAULER REGISTRATION FORM
In accordance with the New Mexico Recycling, Illegal Dumping and Scrap Tire Management Rule (“RIDSTMR”), 20.9.20.26
through 20.9.20.32 NMAC, scrap tire haulers shall register with the New Mexico Environment Department (“NMED”) at least
thirty (30) days prior to operations and every five (5) years thereafter. To register as a scrap tire hauler, complete this application
form providing all required information, including an original $10,000 surety bond. Mail the completed application to the
address above. Assistance and information is available by contacting the Solid Waste Bureau’s Tire Program Coordinator at
(505) 827-0559.
I.
GENERAL INFORMATION:
A.
LEGAL BUSINESS NAME OF SCRAP TIRE HAULER:
NAME
NAME OF OWNER – Not required if a corporation or LLC
DRIVER’S LICENSE NUMBER OF OWNER & STATE OF ISSUE – Not required if a
corporation or LLC
B.
MAILING ADDRESS:
C.
PHYSICAL STREET ADDRESS WHERE VEHICLES WILL BE HOUSED (If
different from the mailing address):
D.
ZONING OF SITE(S) WHERE VEHICLES WILL BE HOUSED (Contact your
local code enforcement/planning department, county manager or other land use
authority):
E.
BUSINESS TELEPHONE:
NEW MEXICO
ENVIRONMENT DEPARTMENT
Solid Waste Bureau
1190 Saint Francis Drive, Room N-2150
P.O. Box 5469
Santa Fe, New Mexico 87502-5469
Telephone: (505) 827-0197 Facsimile: (505) 827-2902
www.env.nm.gov/solid-waste/
SCRAP TIRE HAULER REGISTRATION FORM
In accordance with the New Mexico Recycling, Illegal Dumping and Scrap Tire Management Rule (“RIDSTMR”), 20.9.20.26
through 20.9.20.32 NMAC, scrap tire haulers shall register with the New Mexico Environment Department (“NMED”) at least
thirty (30) days prior to operations and every five (5) years thereafter. To register as a scrap tire hauler, complete this application
form providing all required information, including an original $10,000 surety bond. Mail the completed application to the
address above. Assistance and information is available by contacting the Solid Waste Bureau’s Tire Program Coordinator at
(505) 827-0559.
I.
GENERAL INFORMATION:
A.
LEGAL BUSINESS NAME OF SCRAP TIRE HAULER:
NAME
NAME OF OWNER – Not required if a corporation or LLC
DRIVER’S LICENSE NUMBER OF OWNER & STATE OF ISSUE – Not required if a
corporation or LLC
B.
MAILING ADDRESS:
C.
PHYSICAL STREET ADDRESS WHERE VEHICLES WILL BE HOUSED (If
different from the mailing address):
D.
ZONING OF SITE(S) WHERE VEHICLES WILL BE HOUSED (Contact your
local code enforcement/planning department, county manager or other land use
authority):
E.
BUSINESS TELEPHONE:
Page 2 of 4
F.
E-MAIL ADDRESS (if available):
G.
CONTACT PERSON INFORMATION:
NAME
TELEPHONE
ADDRESS
CITY/STATE/ZIP CODE
E-MAIL ADDRESS (if available)
II.
VEHICLE LIABILITY INSURANCE and REGISTRATION:
A.
NAME OF INSURANCE COMPANY:
B.
ADDRESS:
C.
POLICY NUMBER, AMOUNT OF LIABILITY INSURANCE, EFFECTIVE
AND EXPIRATION DATES:
Policy Number
Amount ($)
Effective Date
Expiration Date
D.
ATTACH A LIST OF THE NUMBER AND TYPES OF VEHICLES,
INCLUDING TRAILERS, USED FOR THE TRANSPORTATION OF SCRAP
TIRES, AND COPIES OF THE CURRENT REGISTRATION FOR EACH
VEHICLE OR TRAILER.
III.
OPERATIONS:
A.
ANTICIPATED START DATE OF OPERATION (for new haulers), HOURS
AND DAYS OF COLLECTION:
Anticipated Start Date
Hours of Collection
Days of Collection
B.
List the names, physical locations and state-issued permit or registration numbers
for all permitted or registered tire recycling or solid waste facilities, civil
engineering applications and/or land reclamation projects to which the scrap tires
will be transported. Attach a separate list if necessary.
[NOTE: For beneficial
agricultural use locations, provide the site’s physical location, nature of the project and the
project owner’s contact information.]
Page 3 of 4
IV.
TIRE STORAGE SITES:
A.
PHYSICAL LOCATION OF ALL TEMPORARY SCRAP TIRE STORAGE
FACILITIES.
[NOTE: If the hauler uses a temporary storage facility to separate scrap tires
from reusable tires, a permit is required if more than 99 scrap tires will be stored at this location
at any one time. If a temporary storage facility is proposed, GPS coordinates shall be included
below. If a permit is necessary, please call the Solid Waste Bureau’s Tire Program Coordinator
at (505) 827-0559.]
B. ZONING OF TEMPORARY SCRAP TIRE STORAGE SITES.
[NOTE: Contact
your local code enforcement/planning department, county manager or other land use
authority.]
V.
BONDING:
APPLICANTS MUST ENCLOSE WITH THIS APPLICATION A SURETY BOND
IN THE AMOUNT OF $10,000.00 WITH ORIGINAL SIGNATURES AND
NOTARY SEAL, USING THE FORM APPROVED BY THE NMED. The form is
available by pointing your browser to https://www.env.nm.gov/solid-waste/forms-
2/#scraptireprogrampermitapplicationforms. Contact your local insurance agent to obtain
the bond. The NMED will accept a bond with this form from any New Mexico licensed
surety; you are not obligated to use any particular company. The Solid Waste Bureau
recommends sending your bond application by USPS certified mail.
VI.
CERTIFICATIONS:
A.
I certify that all drivers and vehicles are, and will continue to be, properly licensed
and registered.
Initials
B.
I certify that each shipment of ten or more scrap tires shall be accompanied by a
scrap tire manifest that complies with 20.9.20.50 NMAC in a format approved by
the NMED.
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C.
If a temporary storage facility is proposed, I certify that no more than 99 scrap
tires will be stored at any one time unless the site is a permitted Tire
Recycling/Storage Facility.
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D.
If a temporary storage facility is proposed, I certify that all scrap tires will be
separated from reusable tires and that the scrap tires will not be stored for a period
exceeding 72 hours.
Initials
Page 4 of 4
E.
If a temporary storage facility is proposed, I certify that the location meets all
zoning and land use regulations, and any applicable restrictive covenants.
Initials
F.
Have any of the applicant’s owner(s) or operator(s) been fined for violation of any
environmental laws of any state or the United States?
Yes
No
Initials
Initials
G.
Have any of the applicant’s owner(s) or operator(s) had any permit or registration
revoked or permanently suspended for cause under environmental laws of any
state or the United States?
Yes
No
Initials
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VII.
The undersigned attests that the information provided upon this registration form,
including all attachments, is true and correct.
SIGNATURE and TITLE
DATE
MAKE A COPY AND RETURN THIS FORM AND ALL REQUIRED ATTACHMENTS TO:
Attention – Tire Program Coordinator
NMED Solid Waste Bureau – Room N-2150
1190 Saint Francis Drive
P.O. Box 5469
Santa Fe, New Mexico 87502-5469
[Revised 1/31/2019]
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